Sleep plays a substantial role in childhood development, from physical growth to sowing the seeds of future learning. A new study from the University of Nebraska-Lincoln establishes that a lack of sleep also can be a detriment to children with mental health concerns.

UNL psychology graduate student Tori Van Dyk studied 6- to 11-year-olds who had previously exhibited behavioral health problems. Over two weeks, sleep was measured with an actigraph watch as well as through questionnaires of the children and their parents. Actigraphy is a non-invasive method of monitoring human rest and activity cycles.

Van Dyk found that sleep duration and quality affect mental health symptoms and that children with mental health problems had poorer sleep.

“We wanted to know, for kids who are already struggling with poor behavior or mood, what relationship might sleep have with these symptoms,” she said. “We found that not only does poor sleep predict worse mental health symptoms but emotional functioning is also a predictor of worse sleep in these youth.”

When sleep was objectively measured using an actigraph watch, children on average were getting just 7.6 hours of sleep each night – well below the recommended nine to 11 hours. When parents were asked how much sleep their children got, their average answer was 8.7 hours per night.

When children reported getting less than optimal sleep, parents reported more internalized mental health symptoms, such as anxiety or depression. When poor sleep was measured objectively, parents were more likely to report their children acting out emotionally.

“Youth are receiving less than the recommended amount, but parents are also overestimating the amount they’re getting,” Van Dyk said. “This could be really problematic because poor sleep and emotional and behavioral symptoms are closely related. But parents aren’t recognizing that sleep is a problem.”

The findings underscore the need for mental-health practitioners to carefully assess and address sleep in children who may exhibit emotional and behavioral concerns, Van Dyk said.

“Sleep concerns may go on the back burner because emotional and behavioral difficulties are so salient,” she said. “This puts some of the responsibility on clinicians to carefully assess sleep. We have good behavioral treatments to optimize sleep but we first need to identify sleep as a problem.

“Further, clinicians should be providing education about healthy sleep, because parents may not recognize that their children should be sleeping at least nine hours at night.”

Van Dyk said early intervention with sleep could change mental-health outcomes as younger children become adolescents.

“This is an age group that presents relatively frequently to mental health treatment for emotional and behavioral problems, and although it’s also true that adolescents are even more sleep-deprived than school-age youth, if we can catch youth early and intervene and optimize sleep earlier on, we may be able to prevent more significant mental health issues moving forward,” she said.

The new study is one of only a handful that has examined sleep in children with emotional and behavioral problems. The research was published in the July issue of the Journal of Pediatric Psychology.

Children and Families Early Childhood Psychology